I. Field of the Invention
The present invention relates to knots for surgical use. More particularly, the present invention relates to a pre-tied suturing knot and holder therefor. Even more particularly, the present invention concerns a knot for use with a surgical needle holder or grasping instrument for combined extrocorporeal and intracorporeal endoscopic surgical procedures and a method for using same.
II. Description of the Relevant Art
After a surgical procedure is performed or when an open injury occurs, tissues must be stitched or sutured to allow the incision or wound to heal, be it either an internal or external procedure. Suturing, that is, the typing of a thread knot at the incision site, is well-known in the art. Moreover, pre-tied sutures and methods of suturing for external surgical use likewise are known, such as is described in U.S. Pat. No. 3,580,256 to Wilkinson et alia. The Wilkinson et alia patent describes a pre-tied suture that is encased in a see-through material, taking the form of a thin, flat wafer. In use, the surgeon stitches the tissue together and then directs the needle through the loops in the wafer and draws it tight in order to make the knot. Clearly, such a convention could not be used for endoscopic and other internal surgical techniques.
In contrast, internal surgery, such as endoscopic surgery, is performed within the interior of a body cavity or hollow organ with the help of an endoscope or similar device to visualize the interior portions of the body where the surgery is to be performed. Miniaturized instruments are utilized to incise and subsequently suture the incision. The surgeon observes the surgical procedures through a visual device whose output is displayed on a video monitor.
In order to perform the suturing in the interior of the body, a curved needle with a fine suturing thread is held with a gun-shaped needle holder or grasper. The needle holder includes a clamp to securely hold the needle. The clamp can be rotated through 360.degree. for maneuvering the needle to perform the desired stitching. The drawbacks of endoscopic and similar surgery are both the distance the suturing site is located inside the body as well as the limited space available within the body for manipulation of the surgical instruments themselves as used for the suturing process. With respect to the latter, a problem arises in manipulating the curved needle for easily tying a knot for closing the surgical incision in situ. Many manipulations of the needle, needle holder and suture thread are required for each suturing knot that is placed at the incision site.
Likewise, the same manipulative problems are encountered in trying to limit blood flow, in tourniquet-fashion, of from blood vessels which are termed "bleeders".
Thus, it is to be appreciated that a pre-tied suture, employable with a needle clamp or grasping instrument, could greatly facilitate endoscopic and other internal body surgical procedures. It is to this to which the present invention is directed.